WithanE Designs
Order Form

To order, print this page, complete the form and mail to: WithanE Designs, 1102 Welcome Ave. N, Golden Valley, MN 55422. Orders over $50 must include 50% of total bill. The remainder, including sales tax and shipping charges, will be billed upon delivery.

All glass is variable and may include iridized, colored, baroque and/or confetti glass. You may specify a type of glass or general color scheme (green, blue, red, pink, etc.) in the Glass/Colors column below, and I will make every effort to honor your request. Please be as specific as possible (light blue, cobalt blue, turquoise blue, etc.) if this is important to you.

Billing Information

Shipping Information (if different from Billing)

Name: Name:
Address: Address:
   
Telephone: Email:

Item (Circle Preference)

Glass/Colors

Price/ unit

Quantity

Total

House Shaped Feeder: Wedge/Curve   $50.00    
Gazebo Feeder   $80.00    
Bird House: Chickadee/Wren   $50.00    
Large Fly-Through Feeder   $90.00    
Small Fly-Through Feeder   $60.00    
Oriole Feeder   $45.00    
Decorative Bird House: Wren/Chickadee/Bluebird   $50.00    
Bevel Glass Boxes   $40.00    
Total amount of order: $
Total enclosed: $

Functional garden art. For you. For a gift. For the birds.

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